NPI | 1285805754 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANE C. SPERRY Registered Agent 678-935-9567 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA PSY003160) |
Enumeration Date | 2008-03-12 |
Last Update Date | 2008-03-12 |